By Jo Cresdee
On Sunday I should be running a marathon. THE marathon – yes, I had a place in the Virgin Money London Marathon and I am not running it – why? Because I am not ready. I have not been able to prepare for this massive assault on my body’s physical capabilities to the extent that I feel is required to take on such a challenge. Luckily for me I have the option of deferring my place. I can put it off and have a go at it next year when I have had time to train.
Why is this relevant? It is relevant because I honestly believe that the closest you can get to labour (without being in labour) is running a long-distance race. Labour is an intense physical experience. It requires you to work a group of muscles, hard, for a prolonged period. It is tough, but it is achievable if you are well prepared and have done your training. It is not something I would attempt without having done a bit of research before the event.
This is where it gets complicated – how do you prepare for this pivotal day when you have never experienced anything like it before? Our culture is now just to go to a class where we sit and listen to a teacher with a flip chart – that is our perception of how to prepare for birth – this intense physical experience. I certainly wouldn’t put myself on a start line of a 26.2-mile race having just watched a PowerPoint presentation about what it might be like to participate in the event. Yeah, I would have a perfectly good understanding of what is happening to my body biologically during the 26.2 miles, but I would not have the physical capability to complete the task.
This is where it gets interesting: I say over and over again that we are perfectly designed to birth. We are – our bodies are miraculous with the complex cocktail of hormones that we produce during labour, combined with muscles which we rarely think about, working in union to bring our babies into this world, but our bodies are also perfectly designed to run enormous distances.
Just because we are designed to do it does not mean that we don’t have to train. We must prepare physically, mentally, emotionally for the task that lies ahead.
On Wednesday we hosted the Maternity Voices Partnership at Suffolk Babies and one of the key things that came out of that meeting is that women are still totally confused about how to prepare for birth and what is available. Hypnobirthing is now provided for free to all women booked with the Ipswich NHS Trust alongside the Suffolk Babies 4-hour Essential Preparation for Birth Workshop. I have recently heard that a lot of women don’t bother with the workshop as they have done hypnobirthing, so I think it is worth examining the options and trying to clarify what is covered in each discipline.
This is an important point. Antenatal education just like any other “sport” has a whole range of different training tools. As a runner I am bombarded with training philosophies, coaches who focus on Cross Fit, PT’s who advise running a huge mileage, training programs that focus on the core. John Reynolds, who I train with, has always told me you are an “experiment of one” and it is the same when it comes to labour. You need to find the right choice for you and your partner. It is not a case of one size fits all.
To begin, let’s consider Hypnobirthing. Hypnotherapy for birth is first documented by an obstetrician in London in the 1920’s called Grantly Dick-Read. (Fun-fact – he was born in Beccles in Suffolk.) He was the first obstetrician to examine the effect of fear on the labouring body and then started to use deep relaxation techniques with his patients. His ideas were expanded famously by Mary Mongan who documented them in her 1989 work, Hypnobirthing – a Celebration of Life. These ideas have been developed, tweaked, played with and rebranded time and again over the years by Wise Hippo & Katharine Graves among others but the key principles are that the birthing mother uses progressive muscle relaxation techniques to slip into a deeply relaxed and hypnotic state where she is visualising or consciously day dreaming to ensure that she reduces the flow of adrenaline (negative in labour) and boosts the release of endorphins (positive in labour).
Hypnobirthing can be awesome. I have used it successfully. I have also found it impossible to use in a birth that involved more medical intervention as the bubble was burst and I could not get into the “zone”. This is a common complaint and whilst there are teachers who will give you alterations that can be used for different birth plans, a certain amount of hypnobirthing does rely on a total unwavering belief that IT WILL WORK. You must have total faith – it is a matter of the mind totally committing to the idea. Bringing it back to our marathon comparison – yup I totally agree, when I stand on a start line it never crosses my mind that I might not finish – I know I will – I have never not finished, but there are times when I have really suffered physically because I have not had the physical qualities needed to run the race with ease – due to a lack of training.
Let’s consider that then. How do you prepare the body for birth? You have loads of options: Aqua Natal Aerobics, Pregnancy Yoga, various PT-led classes tailored to the pregnant body designed to maintain your fitness levels during your pregnancy. They are all beneficial. Exercise in pregnancy will boost your circulation and lymphatic drainage. Pregnancy yoga teaches breathing techniques that can be used in labour to reduce the flow of the negative adrenaline. Yoga can also really help women connect with their bodies, become more self-aware and in touch with their baby and balance the body, making it more likely that your baby will assume optimum positioning for birth, BUT do you get a chance to practice your labour? When I train I do all my core work and strength and conditioning. I work my muscles hard, but I do make sure that I run the practice miles too. Miles on the road are crucial before the big day – no runner would just do work in the gym and then rock up to a race without having jogged around the block a few times.
Which leads me to the Active Birth camp. This philosophy for birth was popularised by Janet Balaskas in the 1980’s in her book “Active Birth”. Janet was a yoga instructor who went on to adapt movements for use during labour. She links these movements to breathing techniques encouraging women to fuel their bodies for birth – the same way that you would when you are running! I think she is onto something with this idea!
We still haven’t really covered all the theory led courses like the NCT and the very traditional courses that you often see on TV where everyone is sat in a circle around a flip chart learning the theory of birth – these courses have their place. They are fantastic for meeting a group of other parents who have a similar due date to you. They build great peer to peer networks and they really explain the physiology of what is going on and the theoretical options. I think these courses are a must, but they must be one part of the plan – not the whole plan!
In my mind there is an ideal solution and that is what Emily, Katie and I are trying to offer. We have thought about it in depth. We have taken our combined experience which is considerable. Emily is a highly experienced midwife who promotes natural birth and works for the Ipswich NHS trust to develop their practice. I have been a trained Doula for nearly 13 years, I have taught antenatal classes in Suffolk for nearly 7. In that time over 2000 women have been to classes with me. I have heard hundreds of birth stories.
We believe that preparation for birth must be holistic. You need a range of “tools”. Just going to one of the classes above would be the equivalent of having a toolbox that only contained a screwdriver. We provide options and that is what everyone needs during labour and birth – a whole group of options. I am tired of listening to people describe “normal” birth. In truth, no such thing exists. There is only the birth that is right for you and your baby on the day of your labour. Your body is perfectly designed to birth – if everything is working as it should. There are times when that does not happen, and you need the information at that point to make empowered and confident decisions so that you retain the ownership of your experience. We now offer every couple in Suffolk the chance to attend a 4-hour workshop that gives them an overview of all these options. Everyone should do it whether they are doing hypnobirthing or not. The Essential Preparation for Birth Workshop is designed by Emily to give the most up to date information about what it is like to birth under the care of the Ipswich NHS Trust. It is specific to our area, it is the most up to date – and it’s FREE!
If you want more theoretical information and to build a network of friends around you who you get to know over a six-week period there is also the Ultimate Antenatal Course – also written by Emily. It really develops all the ideas that are introduced in the Essential Workshop – it is our equivalent of the NCT course that is so inground in peoples psyche but it is cheaper, and every booking contributes towards the provision of the free courses that we offer across Suffolk.
I of course teach the Practical Preparation for Birth course. This is a combination of movement inspired by yoga which is designed to make you feel more comfortable, reduce pregnancy-related ailments and help prepare your body for birth by lengthening key muscles. It incorporates hypnotherapy for birth but also Active Birth theory. The movement is linked with the breathing and the visualisations so that you are building muscle memory – the idea being that on the day your body will just know what to do as you have practised your labour so many times.
I have just started an 18-week Ultra Marathon training plan. I will be fit enough and mentally prepared to run 63 miles at the end of it. I expect it to take me between 12 – 14 hours. If I could get every woman to attend two 6-week courses of Practical Preparation for Birth I would sleep easy at night as I know that combined with one of our more theoretical courses they would have all the tools that they would need to go into labour feeling well-equipped and confident of their abilities.
The truth is that, unlike the London Marathon, labour cannot be deferred – there is a date when it will happen, and we need to think far earlier about how we should prepare for it. You are an experiment of one – give yourself as many options as you can so that you cross the finish line feeling strong.